Pal Indranil, Gupta Amlan, Sengupta Subhabrata
Department of Ear Nose Throat and Head and Neck Surgery, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim, India.
Indian J Otolaryngol Head Neck Surg. 2010 Jan;62(1):92-5. doi: 10.1007/s12070-010-0003-y. Epub 2010 Jun 4.
To present a case of sino-nasal destructive mass initially diagnosed as an inflammatory lesion following punch biopsy from the lesion however the post surgical histopathology was diagnostic of Grade 2 angiocentric immunoproliferative lesion (AIL). The reasons for the initial misdiagnosis are analyzed.
A 76-year-old male patient presenting with progressive bilateral nasal obstruction for 1 year. Repeated punch biopsies from the mass were suggestive of an inflammatory lesion.
The patient underwent surgical exenteration of the mass and the final histopathology report suggested AIL Grade 2. The patient was thereafter treated with chemotherapy and radiotherapy.
Initial superficial punch biopsies lead to incorrect diagnosis leading to an unnecessary surgical exenteration. The explanations for the initial misdiagnosis are given below and appropriate diagnostic protocols, mode and depth of biopsy are suggested based on the case study.
报告一例鼻窦破坏性肿物病例，该肿物经病灶穿刺活检最初诊断为炎性病变，但术后组织病理学诊断为2级血管中心性免疫增殖性病变（AIL）。分析最初误诊的原因。
一名76岁男性患者，渐进性双侧鼻塞1年。对肿物反复进行穿刺活检提示为炎性病变。
患者接受了肿物切除手术，最终组织病理学报告提示为2级AIL。此后患者接受了化疗和放疗。
最初的浅表穿刺活检导致诊断错误，进而进行了不必要的肿物切除手术。以下给出了最初误诊的原因，并基于该病例研究提出了合适的诊断方案、活检方式及深度。
